<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Company_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-company_id" min="0" data-rule="required" data-source="company/index" class="form-control selectpage" name="row[company_id]" type="text" value="{$row.company_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Department_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-department_id" min="0" data-rule="required" data-source="department/index" class="form-control selectpage" name="row[department_id]" type="text" value="{$row.department_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Contract_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-contract_id" data-rule="required" min="0" data-source="contract/index" class="form-control selectpage" name="row[contract_id]" type="text" value="{$row.contract_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Elderly_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-elderly_id" data-rule="required" min="0" data-source="elderly/index" class="form-control selectpage" name="row[elderly_id]" type="text" value="{$row.elderly_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Plan_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-plan_id" min="0" data-rule="required" data-source="plan/index" class="form-control selectpage" name="row[plan_id]" type="text" value="{$row.plan_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Class')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-class" class="form-control" name="row[class]" type="number" value="{$row.class|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-type" data-rule="required" min="0" class="form-control" name="row[type]" type="number" value="{$row.type|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Execute_role_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-execute_role_id" min="0" data-rule="required" data-source="execute/role/index" class="form-control selectpage" name="row[execute_role_id]" type="text" value="{$row.execute_role_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Title')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-title" data-rule="required" class="form-control" name="row[title]" type="text" value="{$row.title|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Task_date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-task_date" data-rule="required" min="0" class="form-control" name="row[task_date]" type="number" value="{$row.task_date|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Plan_start_date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-plan_start_date" class="form-control" name="row[plan_start_date]" type="text" value="{$row.plan_start_date|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Plan_end_date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-plan_end_date" class="form-control" name="row[plan_end_date]" type="text" value="{$row.plan_end_date|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Drug_period_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-drug_period_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[drug_period_time]" type="text" value="{:$row.drug_period_time?datetime($row.drug_period_time):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Drug_execution_way')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-drug_execution_way" class="form-control" name="row[drug_execution_way]" type="number" value="{$row.drug_execution_way|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Real_start_date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-real_start_date" class="form-control" name="row[real_start_date]" type="text" value="{$row.real_start_date|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Real_end_date')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-real_end_date" class="form-control" name="row[real_end_date]" type="text" value="{$row.real_end_date|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Points')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-points" class="form-control" name="row[points]" type="text" value="{$row.points|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Images')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-images" class="form-control" size="50" name="row[images]" type="text" value="{$row.images|htmlentities}">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-images" class="btn btn-danger faupload" data-input-id="c-images" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="true" data-preview-id="p-images"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-images" class="btn btn-primary fachoose" data-input-id="c-images" data-mimetype="image/*" data-multiple="true"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-images"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-images"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Execution_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-execution_number" min="0" class="form-control" name="row[execution_number]" type="number" value="{$row.execution_number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Finish_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-finish_number" min="0" class="form-control" name="row[finish_number]" type="number" value="{$row.finish_number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-remark" class="form-control" name="row[remark]" type="text" value="{$row.remark|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Finish_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-finish_status" class="form-control" name="row[finish_status]" type="number" value="{$row.finish_status|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Finish_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-finish_id" min="0" data-rule="required" data-source="finish/index" class="form-control selectpage" name="row[finish_id]" type="text" value="{$row.finish_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Finish_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-finish_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[finish_time]" type="text" value="{:$row.finish_time?datetime($row.finish_time):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Finish_remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-finish_remark" class="form-control" name="row[finish_remark]" type="text" value="{$row.finish_remark|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Task_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-task_status" data-rule="required" min="0" class="form-control" name="row[task_status]" type="number" value="{$row.task_status|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Task_status_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-task_status_id" min="0" data-rule="required" data-source="task/status/index" class="form-control selectpage" name="row[task_status_id]" type="text" value="{$row.task_status_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Task_status_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-task_status_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[task_status_time]" type="text" value="{:$row.task_status_time?datetime($row.task_status_time):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Task_status_remark')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-task_status_remark" class="form-control" name="row[task_status_remark]" type="text" value="{$row.task_status_remark|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Auxiliary_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-auxiliary_type" min="0" class="form-control" name="row[auxiliary_type]" type="number" value="{$row.auxiliary_type|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Doctors_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-doctors_id" min="0" data-rule="required" data-source="doctors/index" class="form-control selectpage" name="row[doctors_id]" type="text" value="{$row.doctors_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Drug_self')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-drug_self" class="form-control" name="row[drug_self]" type="number" value="{$row.drug_self|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Drug_self_care')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-drug_self_care" min="0" class="form-control" name="row[drug_self_care]" type="number" value="{$row.drug_self_care|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Drug_metering')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-drug_metering" min="0" class="form-control" name="row[drug_metering]" type="number" value="{$row.drug_metering|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Drug_unit')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-drug_unit" class="form-control" name="row[drug_unit]" type="text" value="{$row.drug_unit|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Drug_usage')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-drug_usage" class="form-control" name="row[drug_usage]" type="text" value="{$row.drug_usage|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-status" min="0" class="form-control" name="row[status]" type="number" value="{$row.status|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Created_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-created_id" data-rule="required" min="0" data-source="created/index" class="form-control selectpage" name="row[created_id]" type="text" value="{$row.created_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Created_at')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-created_at" data-rule="required" min="0" class="form-control" name="row[created_at]" type="number" value="{$row.created_at|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Updated_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-updated_id" min="0" data-rule="required" data-source="updated/index" class="form-control selectpage" name="row[updated_id]" type="text" value="{$row.updated_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Updated_at')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-updated_at" min="0" class="form-control" name="row[updated_at]" type="number" value="{$row.updated_at|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Task_start_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-task_start_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[task_start_time]" type="text" value="{:$row.task_start_time?datetime($row.task_start_time):''}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
